In recent years, the transgender community has made great strides in the movement for equality, particularly on issues such as marriage and workplace discrimination.
Despite these gains, transgender people are still impeded by stigmatization, intolerance, and high rates of mental illness and substance abuse.
It is estimated that between 20 to 30 percent of gay and transgender people abuse substances, which is two to three times higher than that of the general population.
Luckily, there are resources and treatment options for substance use available for the transgender community throughout the United States.
What It Means To Be Transgender
When we’re born, most people who were labeled male or female grow up to be that same gender. Transgender people are individuals whose gender identity differs from the gender they were assigned at birth.
Being transgender means different things depending on the person, and there’s no correct way to be transgender. People who identify as transgender occupy a spectrum of experiences in both the way they look and feel about themselves.
A transgender person can be gay, lesbian, straight, or bisexual, just like someone who’s cis-gendered. Gender identity does not necessarily predict who someone may be sexually or romantically attracted to.
The best way to understand what being transgender means is to talk with transgender people and listen to their lived experiences.
Rates Of Alcohol And Drug Addiction In The Transgender Community
According to the Centers for Disease Control and Prevention (CDC), transgender people represent less than one percent of the population.
While there is little data on the rate of substance abuse in the gay and transgender community, studies point to a substantially higher rate than heterosexual, cisgender people in the same age groups.
The following information is based on studies conducted through the Substance Abuse and Mental Health Services Administration (SAMHSA).
Rates Of Alcohol Use Disorder
Twenty-five percent of transgender and gay people admit to abusing alcohol on a monthly basis, compared to five to ten percent of the general population.
Rates Of Prescription Drug Abuse
Transgender people are two to three times more likely to misuse prescription pain medications, such as opioids, than gay, lesbian, or straight cisgender people.
Rates Of Illicit Drug Abuse
Illicit drug use, such as cocaine and methamphetamine abuse among transgender individuals is approximately 2.5 times higher than the general population.
Risk Factors For Addiction Among Transgender People
Identifying as transgender does not mean a person is inherently more inclined to abuse drugs and alcohol. However, there are a number of factors that may contribute to the prevalence of addiction in this community.
Mental Health Disorders
According to surveys conducted by LGBTQ+ rights organizations such as the Human Rights Campaign, the number of transgender people with mental health issues is higher than other population groups.
Mental health disorders such as depression, bipolar disorder, and anxiety disorder can contribute to substance abuse. Transgender people may feel that drugs or alcohol help them cope with the symptoms of mental illness.
Gender dysphoria describes the stress and sense of unease that a person may feel because of a disparity between their gender identity and their biological sex.
Symptoms of gender dysphoria may include a desire to be treated as the opposite gender or a strong need to no longer have the primary sex organs of their assigned gender at birth.
Some transgender people may develop severe depression due to gender dysphoria and may turn to substance abuse as a result.
Post-Traumatic Stress Disorder (PTSD)
PTSD is a condition that arises after a traumatic event such as witnessing or experiencing violence or sexual assault.
People with PTSD will oftentimes experience flashbacks, nightmares, changes in mood or thinking, and a heightened state of anxiety.
PTSD and addiction triggers among transgender people can intertwine and intensify the effects of both disorders.
Family History Of Substance Abuse
The Nation Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that a family history of addiction is one of the most significant risk factors for developing a substance use disorder.
If a person’s family member, such as a parent or sibling, has developed an addiction to drugs or alcohol, the chances are higher that they will develop substance abuse issues of their own.
Treatment Options For Transgender People With Substance Use Disorders
There are several evidence-based addiction treatment methods that are effective for transgender people with substance use disorder.
Additionally, some treatment programs may include individual or group counseling for issues such as gender dysphoria, sexual identity, and more to target the underlying causes of addiction.
Medication-Assisted Treatment (MAT)
MAT refers to the use of medications, in combination with behavioral therapies to help reestablish normal brain function, reduce substance cravings and prevent relapse.
Common medications prescribed during MAT include methadone, naltrexone, and buprenorphine for opioid use disorder.
Cognitive Behavioral Therapy (CBT)
One of the most common substance abuse treatments for transgender people is cognitive behavioral therapy (CBT).
This type of therapy involves attempting to change thinking patterns in clients with substance use disorders and other mental health issues.
Transgender people with severe drug or alcohol addiction may benefit from short-term or long-term inpatient treatment at a rehab facility.
Residential treatment centers offer highly monitored, intensive, live-in programs where clients are supervised by trained staff.
Outpatient treatment refers to a variety of services such as individual therapy, group therapy, or support groups that a person may attend on a weekly basis. These programs don’t require the client to live at the facility.
After a transgender person finishes the early phase of their residential or outpatient treatment, aftercare services are often provided to help people in addiction recovery adapt to everyday life.
Aftercare plans may include additional resources, enrollment in activities, or interventions designed to assist a person in coping with stress, cravings, and potential triggers.
Barriers To Transgender Substance Abuse Treatment
Transgender people seeking treatment for substance abuse may be presented with an array of barriers to dissuade them from getting the help they need.
Some of the problems that may arise include:
- inadequate access to affordable healthcare services
- fear of physical or verbal abuse from other clients or staff
- requirements for wearing only clothing or cosmetics related to their gender assigned at birth
- housing that requires a transgender person to live with members of the opposite gender identity
- misgendering, or using the transgendered person’s original birth name or pronoun instead of their current chosen name
Issues such as these may be rare in occurrence but can prove to be extremely damaging and offensive to transgender people during addiction recovery.
Is Hormone Replacement Therapy Offered In Addiction Treatment?
Hormone replacement therapy (HRT) allows a person to change their physical appearance to match their gender identity by manipulating the estrogen and testosterone levels in their body.
Depending on the drug rehab center, transgender people may not have continued access to the pills, patches, or shots they use for gender-affirming hormone therapy when they enter a treatment program.
Some facilities specialize in issues related to LGBTQIA+ people, including the administration of HRT. To avoid a lapse in HRT, transgender clients can contact the rehab center directly and ask about their policy on hormone therapy.
Tips For Transgender Loved Ones With Behavioral Health Issues
If you or a transgender loved one are seeking behavioral health treatment, there are a number of tips that may ease the process of getting help and achieving long-term sobriety.
1. Find A Trans-Affirming Therapist
Be sure that the treatment program you attend offers gender affirmative therapy. This type of therapy requires therapists to get continued education and training in gender diversity.
2. Create A Robust Support System
Family support and connection are one of the most important factors in the lives of transgender people, particularly individuals with mental health or substance abuse issues.
There are also support groups available at LGBTQ centers across the United States where people can find a supportive community.
3. Obtain Adequate Health Insurance
Obtaining health care insurance will greatly increase the chances of finding an appropriate treatment program for transgender people.
If private insurance is unaffordable, each state in the nation offers a Medicaid program so people with lesser financial means can get the healthcare they need.
4. Learn About Policies That Affect The LGBTQ Community
Depending on where you live, there may be laws or policies in place that discriminate against transgender people.
It’s important to learn about the challenges that transgender people face as well as the goals of transgender advocates.
5. Be Aware Of Gendered Language
Consider changing your language to avoid making assumptions about people’s pronouns and gender.
Many transgender people may not care if they’re misgendered, but others may find it triggering or highly offensive.
Resources For Transgendered People In Need Of Addiction Treatment
Finding treatment for substance use can be stressful, but help is available in the form of rehab programs, government resources, and nonprofit organizations dedicated to supporting the transgender community.
Drug And Alcohol Treatment Resources For LGBTQ+ People
- Alcoholics Anonymous (AA) — Through AA, people from all walks of life can find alcohol addiction support groups and 12-step programs.
- Centers for Disease Control and Prevention (CDC) — The CDC provides an array of data that can help people understand the prevalence of addiction and mental health disorders in the LGBTQ community.
- National Institute on Drug Abuse (NIDA) — the NIDA offers information on the physical effects of drug and alcohol abuse, as well as useful information for sexual minorities seeking help.
- Substance Abuse and Mental Health Services Administration (SAMHSA) — Here, transgender people can get help locating a local treatment center, or find a government grant for substance use treatment.
Support For Transitioning People
- Gay and Lesbian Alliance Against Defamation (GLAAD) — GLAAD is an organization dedicated to accelerating acceptance for LGBTQ people in media and provoking dialogue that leads to cultural change.
- Human Rights Campaign — The Human Rights Campaign is the largest LGBTQIA+ advocacy organization in the United States. Here, people can find resources such as sexual health information, employment opportunities, scholarship databases, and more.
- Planned Parenthood — Planned Parenthood provides a range of free and low-cost health care services including preventive care, birth control, and treatment for sexually transmitted infections.
Resources For Transgender Youth
- It Gets Better Project — The It Gets Better Project empowers LGBTQIA+ youth through inspiring media programming, educational resources, and access to several community-based service providers.
- NIDA for Teens — NIDA for Teens offers a wealth of information about the effects of drugs and alcohol for adolescents, their parents, and educators.
- The Trevor Project — The Trevor Project provides information and support to LGBTQ young people. Free counseling is available here for teens thinking about self harm or wanting to discuss their gender identity and sexual orientation.
Legal Resources For Transgender People
- American Civil Liberties Union (ACLU) — The ACLU is a non-profit organization dedicated to protecting and defending American civil rights. Here, you can learn more about how to exercise your rights and what to do when your rights are violated.
Resources For Transgender Veterans
- U.S. Department Of Veterans Affairs (VA) — LGBT veterans can receive free addiction treatment services including counseling, mental health services, and resources for homeless veterans at their local VA medical center.
- Vets4Warriors — Here, LGBTQ+ veterans can find 24/7 confidential peer support for themselves and their family members by phone, chat, text, or email correspondence.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Substance Use Disorder in Transgender and Nonbinary People
- Prevalence of Addictions among Transgender and Gender Diverse Subgroups